Fugue state
Encyclopedia
A fugue state, formally dissociative fugue or psychogenic fugue (DSM-IV Dissociative Disorders 300.13), is a rare psychiatric disorder characterized by reversible amnesia
for personal identity, including the memories, personality
and other identifying characteristics of individuality. The state is usually short-lived (ranging from hours to days), but can last months or longer. Dissociative fugue usually involves unplanned travel or wandering, and is sometimes accompanied by the establishment of a new identity. After recovery from fugue, previous memories usually return intact, but there is complete amnesia for the fugue episode. Additionally, an episode is not characterized as a fugue if it can be related to the ingestion of psychotropic substances, to physical trauma, to a general medical condition, or to psychiatric conditions such as delirium, dementia, bipolar disorder or depression. Fugues are usually precipitated by a stressful episode, and upon recovery there may be amnesia for the original stressor (Dissociative Amnesia).
of the fugue state is related to Dissociative Amnesia
, (DSM-IV Codes
300.12) which has several other subtypes: Selective Amnesia, Generalised Amnesia, Continuous Amnesia, Systematised Amnesia, in addition to the subtype Dissociative Fugue.
Unlike retrograde amnesia
(which is popularly referred to simply as "amnesia", the state where someone forgets events before brain damage), Dissociative Amnesia
is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, DSM-IV Codes
291.1 & 292.83) or a neurological or other general medical condition (e.g., Amnestic Disorder due to a head trauma, DSM-IV Codes
294.0). It is a complex neuropsychological process.
As the person experiencing a Dissociative Fugue may have recently suffered the reappearance of an event or person representing an earlier life trauma, the emergence of an armoring or defensive personality seems to be for some, a logical apprehension of the situation.
Therefore, the terminology fugue state may carry a slight linguistic distinction from Dissociative Fugue, the former implying a greater degree of motion. For the purposes of this article then, a fugue state would occur while one is acting out a Dissociative Fugue.
The DSM-IV defines as:
The Merck Manual defines Dissociative Fugue as:
In support of this definition, the Merck Manual further defines Dissociative Amnesia
as:
disappeared on 3 December 1926 only to reappear eleven days later in a hotel in Harrogate, apparently with no memory of the events which happened during that time span.
Shirley Ardell Mason
also known as "Sybil" would disappear and then reappear with no recollection of what happened during the time span. She recalls "being here and then not here" and having no identity of herself; it should be noted that she also suffered from what was formerly called "Multiple Personality Disorder".
Jody Roberts, a reporter for the Tacoma News Tribune
, went missing in 1985, only to be found 12 years later in Sitka, Alaska, living under the name of "Jane Dee Williams." While there were some initial suspicions that she had been faking amnesia, some experts have come to believe that she genuinely suffered a protracted fugue state.
David Fitzpatrick, a sufferer of dissociative fugue disorder, from the United Kingdom, was profiled on Channel Five's television series Extraordinary People. He entered a fugue state on December 22, 2005, and is still working on regaining his entire life's memories.
Hannah Upp, a teacher from New York
, went missing on August 28, 2008. She was rescued from the New York Harbor
on September 16 with no recollection of the time in between. The episode was diagnosed as dissociative fugue.
novel The Last Gentleman
suffers from frequent fugue states that keep him from having a stable personality.
During the Doctor Who
episode The Next Doctor it is discovered by the Tenth Doctor that the future incarnation of himself is actually a man named Jackson Lake, suffering a fugue state after the loss of his family to the Cybermen.
In David Lynch
's series Twin Peaks
, a girl named Ronette Pulaski is found walking down train tracks in a fugue state (though the term is not actually used).
In Lynch's 1997 film Lost Highway, Bill Pullman
's character suffers a fugue state.
In the Buffy the Vampire Slayer (TV series) episode Bring on the Night (Buffy the Vampire Slayer) (season 7 episode 10), Dawn says in reference to Andrew, "Or maybe he's in a fugue state?"
In the Star Trek: The Next Generation
episode Tin Man, a telepath
, having distantly communicated with the titular alien, is told in a follow-up medical exam “Your brain activity suggests that you're coming out of a sort of fugue, or seizure.”
In the Film and Novel Primal Fear
the supporting character Aaron Stampler
appears to slip frequently in to and out of a fugue state but it is later revealed to be an act.
In the Australian television series Neighbours
a main character Harold Bishop
went AWOL for five years in a putative fugue state.
In Chapter 7 of The Maltese Falcon, by Dashiell Hammett, Spade tells Brigid a story about a man who, after a near-death experience, disappears, abandoning his wife and children, only to be found years later, settled down to the same kind of life with the same kind of family.
In the TV show Breaking Bad
Walt claims to have been in a fugue state to account for the time he was kidnapped and held captive by his meth distributor. He appeared naked and confused in a supermarket in an effort to support his false condition.
Amnesia
Amnesia is a condition in which one's memory is lost. The causes of amnesia have traditionally been divided into categories. Memory appears to be stored in several parts of the limbic system of the brain, and any condition that interferes with the function of this system can cause amnesia...
for personal identity, including the memories, personality
Personality psychology
Personality psychology is a branch of psychology that studies personality and individual differences. Its areas of focus include:* Constructing a coherent picture of the individual and his or her major psychological processes...
and other identifying characteristics of individuality. The state is usually short-lived (ranging from hours to days), but can last months or longer. Dissociative fugue usually involves unplanned travel or wandering, and is sometimes accompanied by the establishment of a new identity. After recovery from fugue, previous memories usually return intact, but there is complete amnesia for the fugue episode. Additionally, an episode is not characterized as a fugue if it can be related to the ingestion of psychotropic substances, to physical trauma, to a general medical condition, or to psychiatric conditions such as delirium, dementia, bipolar disorder or depression. Fugues are usually precipitated by a stressful episode, and upon recovery there may be amnesia for the original stressor (Dissociative Amnesia).
Clinical definition
The etiologyEtiology
Etiology is the study of causation, or origination. The word is derived from the Greek , aitiologia, "giving a reason for" ....
of the fugue state is related to Dissociative Amnesia
Psychogenic amnesia
Psychogenic amnesia, also known as functional amnesia or dissociative amnesia, is a memory disorder characterized by extreme memory loss that is caused by extensive psychological stress and that cannot be attributed to a known neurobiological cause...
, (DSM-IV Codes
DSM-IV Codes
Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, also known as DSM-IV-TR, is a manual published by the American Psychiatric Association that includes all currently recognized mental health disorders...
300.12) which has several other subtypes: Selective Amnesia, Generalised Amnesia, Continuous Amnesia, Systematised Amnesia, in addition to the subtype Dissociative Fugue.
Unlike retrograde amnesia
Retrograde amnesia
Retrograde amnesia is a loss of access to events that occurred, or information that was learned, before an injury or the onset of a disease....
(which is popularly referred to simply as "amnesia", the state where someone forgets events before brain damage), Dissociative Amnesia
Psychogenic amnesia
Psychogenic amnesia, also known as functional amnesia or dissociative amnesia, is a memory disorder characterized by extreme memory loss that is caused by extensive psychological stress and that cannot be attributed to a known neurobiological cause...
is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, DSM-IV Codes
DSM-IV Codes
Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, also known as DSM-IV-TR, is a manual published by the American Psychiatric Association that includes all currently recognized mental health disorders...
291.1 & 292.83) or a neurological or other general medical condition (e.g., Amnestic Disorder due to a head trauma, DSM-IV Codes
DSM-IV Codes
Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, also known as DSM-IV-TR, is a manual published by the American Psychiatric Association that includes all currently recognized mental health disorders...
294.0). It is a complex neuropsychological process.
As the person experiencing a Dissociative Fugue may have recently suffered the reappearance of an event or person representing an earlier life trauma, the emergence of an armoring or defensive personality seems to be for some, a logical apprehension of the situation.
Therefore, the terminology fugue state may carry a slight linguistic distinction from Dissociative Fugue, the former implying a greater degree of motion. For the purposes of this article then, a fugue state would occur while one is acting out a Dissociative Fugue.
The DSM-IV defines as:
- sudden, unexpected travel away from home or one's customary place of work, with inability to recall one's past,
- confusion about personal identity, or the assumption of a new identity, or
- significant distress or impairment.
The Merck Manual defines Dissociative Fugue as:
- One or more episodes of amnesia in which the inability to recall some or all of one's past and either the loss of one's identity or the formation of a new identity occur with sudden, unexpected, purposeful travel away from home.
In support of this definition, the Merck Manual further defines Dissociative Amnesia
Psychogenic amnesia
Psychogenic amnesia, also known as functional amnesia or dissociative amnesia, is a memory disorder characterized by extreme memory loss that is caused by extensive psychological stress and that cannot be attributed to a known neurobiological cause...
as:
- An inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by normal forgetfulness.
Diagnosis
A doctor may suspect dissociative fugue when people seem confused about their identity or are puzzled about their past or when confrontations challenge their new identity or absence of one. The doctor carefully reviews symptoms and does a physical examination to exclude physical disorders that may contribute to or cause memory loss. A psychologic examination is also done. Sometimes dissociative fugue cannot be diagnosed until people abruptly return to their pre-fugue identity and are distressed to find themselves in unfamiliar circumstances. The diagnosis is usually made retroactively when a doctor reviews the history and collects information that documents the circumstances before people left home, the travel itself, and the establishment of an alternative life.Prognosis
The DSM-IV-TR states that the fugue may have a duration from hours to months and recovery is usually rapid. However, some cases may be refractory. An individual usually only has a single episode.Case studies
Agatha ChristieAgatha Christie
Dame Agatha Christie DBE was a British crime writer of novels, short stories, and plays. She also wrote romances under the name Mary Westmacott, but she is best remembered for her 66 detective novels and 14 short story collections , and her successful West End plays.According to...
disappeared on 3 December 1926 only to reappear eleven days later in a hotel in Harrogate, apparently with no memory of the events which happened during that time span.
Shirley Ardell Mason
Shirley Ardell Mason
Shirley Ardell Mason was an American psychiatric patient and commercial artist who was reputed to have multiple personality disorder. Her life was fictionalized in 1973 in the book Sybil, and two films of the same name were made in 1976 and 2007...
also known as "Sybil" would disappear and then reappear with no recollection of what happened during the time span. She recalls "being here and then not here" and having no identity of herself; it should be noted that she also suffered from what was formerly called "Multiple Personality Disorder".
Jody Roberts, a reporter for the Tacoma News Tribune
Tacoma News Tribune
The News Tribune is a daily newspaper in Tacoma, Washington, in the United States.-History:It can trace its origins back to the founding of the weekly Tacoma Ledger by R.F. Radabaugh in 1880. The next year, H.C. Patrick founded The News, another weekly. Both papers became dailies in 1883. In 1898,...
, went missing in 1985, only to be found 12 years later in Sitka, Alaska, living under the name of "Jane Dee Williams." While there were some initial suspicions that she had been faking amnesia, some experts have come to believe that she genuinely suffered a protracted fugue state.
David Fitzpatrick, a sufferer of dissociative fugue disorder, from the United Kingdom, was profiled on Channel Five's television series Extraordinary People. He entered a fugue state on December 22, 2005, and is still working on regaining his entire life's memories.
Hannah Upp, a teacher from New York
New York
New York is a state in the Northeastern region of the United States. It is the nation's third most populous state. New York is bordered by New Jersey and Pennsylvania to the south, and by Connecticut, Massachusetts and Vermont to the east...
, went missing on August 28, 2008. She was rescued from the New York Harbor
New York Harbor
New York Harbor refers to the waterways of the estuary near the mouth of the Hudson River that empty into New York Bay. It is one of the largest natural harbors in the world. Although the U.S. Board of Geographic Names does not use the term, New York Harbor has important historical, governmental,...
on September 16 with no recollection of the time in between. The episode was diagnosed as dissociative fugue.
Pop culture references
Will Barrett, the protagonist of Walker Percy'sWalker Percy
Walker Percy was an American Southern author whose interests included philosophy and semiotics. Percy is best known for his philosophical novels set in and around New Orleans, Louisiana, the first of which, The Moviegoer, won the National Book Award for Fiction in 1962...
novel The Last Gentleman
The Last Gentleman
The Last Gentleman is a 1966 novel by Walker Percy. The story centers on the character of Williston Bibb Barret, a man born in the Mississippi Delta who has since moved to New York City. He suffers from a "nervous condition," which causes him to experience fits of déjà vu and amnesiac fugues. He...
suffers from frequent fugue states that keep him from having a stable personality.
During the Doctor Who
Doctor Who
Doctor Who is a British science fiction television programme produced by the BBC. The programme depicts the adventures of a time-travelling humanoid alien known as the Doctor who explores the universe in a sentient time machine called the TARDIS that flies through time and space, whose exterior...
episode The Next Doctor it is discovered by the Tenth Doctor that the future incarnation of himself is actually a man named Jackson Lake, suffering a fugue state after the loss of his family to the Cybermen.
In David Lynch
David Lynch
David Keith Lynch is an American filmmaker, television director, visual artist, musician and occasional actor. Known for his surrealist films, he has developed his own unique cinematic style, which has been dubbed "Lynchian", and which is characterized by its dream imagery and meticulous sound...
's series Twin Peaks
Twin Peaks
Twin Peaks is an American television serial drama created by David Lynch and Mark Frost. The series follows the investigation headed by FBI Special Agent Dale Cooper , of the murder of a popular teenager and homecoming queen, Laura Palmer...
, a girl named Ronette Pulaski is found walking down train tracks in a fugue state (though the term is not actually used).
In Lynch's 1997 film Lost Highway, Bill Pullman
Bill Pullman
William James "Bill" Pullman is an American film, television, and stage actor. Pullman made his film debut in the supporting role of Earl Mott in the 1986 film Ruthless People. He has since gone on to star in other films, including Spaceballs, Independence Day, Lost Highway, Casper and Scary Movie 4...
's character suffers a fugue state.
In the Buffy the Vampire Slayer (TV series) episode Bring on the Night (Buffy the Vampire Slayer) (season 7 episode 10), Dawn says in reference to Andrew, "Or maybe he's in a fugue state?"
In the Star Trek: The Next Generation
Star Trek: The Next Generation
Star Trek: The Next Generation is an American science fiction television series created by Gene Roddenberry as part of the Star Trek franchise. Roddenberry, Rick Berman, and Michael Piller served as executive producers at different times throughout the production...
episode Tin Man, a telepath
Betazoid
In the fictional Star Trek universe, Betazoids are a sentient humanoid species from the planet Betazed, a member of the United Federation of Planets.-Overview:...
, having distantly communicated with the titular alien, is told in a follow-up medical exam “Your brain activity suggests that you're coming out of a sort of fugue, or seizure.”
In the Film and Novel Primal Fear
Primal Fear
Primal Fear may refer to:* Primal Fear , a German power metal band** Primal Fear , their debut album* Primal Fear , a 1993 thriller novel by William Diehl* Primal Fear , a 1996 film based on Diehl's novel...
the supporting character Aaron Stampler
Aaron Stampler
Aaron Stampler is a fictional character in William Diehl's 1993 novel Primal Fear and its two sequels, Show of Evil and Reign in Hell .-In Primal Fear:...
appears to slip frequently in to and out of a fugue state but it is later revealed to be an act.
In the Australian television series Neighbours
Neighbours
Neighbours is an Australian television soap opera first broadcast on the Seven Network on 18 March 1985. It was created by TV executive Reg Watson, who proposed the idea of making a show that focused on realistic stories and portrayed adults and teenagers who talk openly and solve their problems...
a main character Harold Bishop
Harold Bishop
Harold Bishop is a fictional character from the Australian soap opera Neighbours, played by Ian Smith. He made his first on-screen appearance on 30 January 1987. Smith was offered a role by Neighbours creator and executive producer Reg Watson...
went AWOL for five years in a putative fugue state.
In Chapter 7 of The Maltese Falcon, by Dashiell Hammett, Spade tells Brigid a story about a man who, after a near-death experience, disappears, abandoning his wife and children, only to be found years later, settled down to the same kind of life with the same kind of family.
In the TV show Breaking Bad
Breaking Bad
Breaking Bad is an American television drama series created and produced by Vince Gilligan. Set and produced in Albuquerque, New Mexico, Breaking Bad is the story of Walter White , a struggling high school chemistry teacher who is diagnosed with advanced lung cancer at the beginning of the series...
Walt claims to have been in a fugue state to account for the time he was kidnapped and held captive by his meth distributor. He appeared naked and confused in a supermarket in an effort to support his false condition.
See also
- Structured Clinical Interview for DSM-IVStructured Clinical Interview for DSM-IVThe Structured Clinical Interview for DSM-IV Axis I Disorders is a diagnostic exam used to determine DSM-IV Axis I disorders and Axis II disorders . There are at least 700 published studies in which the SCID was the diagnostic instrument used...
- Dissociative DisordersDissociative disordersDissociative disorders are defined as conditions that involve disruptions or breakdowns of memory, awareness, identity and/or perception. See also dissociation. People with dissociative disorders are able to escape from reality involuntarily...
(DSM-IV Dissociative Disorders) - Dissociative Identity DisorderDissociative identity disorderDissociative identity disorder is a psychiatric diagnosis and describes a condition in which a person displays multiple distinct identities , each with its own pattern of perceiving and interacting with the environment....
(formerly Multiple Personality Disorder) (DSM-IV Dissociative Disorders 300.14) - Psychogenic amnesiaPsychogenic amnesiaPsychogenic amnesia, also known as functional amnesia or dissociative amnesia, is a memory disorder characterized by extreme memory loss that is caused by extensive psychological stress and that cannot be attributed to a known neurobiological cause...
; Dissociative Amnesia (formerly Psychogenic Amnesia) (DSM-IV Dissociative Disorders 300.12) - Depersonalization DisorderDepersonalizationDepersonalization is an anomaly of the mechanism by which an individual has self-awareness. It is a feeling of watching oneself act, while having no control over a situation. Sufferers feel they have changed, and the world has become less real, vague, dreamlike, or lacking in significance...
(DSM-IV Dissociative Disorders 300.6) - Dissociation (psychology)
External links
- "Dissociative Fugue" from the Mental Health Matters website.
- "Dissociative Fugue" from the Merck & Co.Merck & Co.Merck & Co., Inc. , also known as Merck Sharp & Dohme or MSD outside the United States and Canada, is one of the largest pharmaceutical companies in the world. The Merck headquarters is located in Whitehouse Station, New Jersey, an unincorporated area in Readington Township...
website.